Following Bariatric Surgery, Contraception and Pregnancy Planning
November 23, 2021
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One of the obesity-related co-morbidities, infertility, usually improves following weight loss via bariatric surgical operations. As a result, clinicians who specialize in women’s health should not only be familiar with the surgery and understand the long-term weight loss goals, but also provide appropriate contraception and pregnancy counseling to women who have had bariatric surgery, regardless of whether they want to have children in the future.
Obesity and other chronic medical conditions cause hurdles to contraceptive advice. Studies show that oral contraceptive may be less effective following bariatric surgery due to lower absorption. Obesity persists after bariatric surgery, which affects contraceptive planning. Unfortunately, current practice is limited owing to a lack of information about the efficiency and safety of contraception after bariatric surgery, although a recent comprehensive analysis found that there is unlikely to be a substantial drop in efficacy for oral contraceptive tablets.
Because the most weight loss happens in the first 12-18 months following surgery, numerous groups and writers advise waiting at least 12 months before getting pregnant. This is based on the premise that having a baby during a period of starvation might result in complications such as low birth weight or abnormalities. However, for people who are older or have infertility, the advice to delay pregnancy may limit family planning options.
The number of bariatric procedures done has risen considerably in recent years. Clinicians that specialize in women’s health should be knowledgeable with the procedure, its long-term aims, and the possible influence on future pregnancies, given that the majority of patients are female and of reproductive age. Most pregnancies following bariatric surgery have a satisfactory result when compared to controls. Strict attention to dietary requirements and supplementation in the case of shortfalls is critical while delivering prenatal care to this specific group. A multidisciplinary team approach to care, a unique screening tool for gestational diabetes, a comprehensive examination of any gastrointestinal issues, and appropriate counseling for gravitas who remain obese throughout pregnancy are all important concerns. Long-term maternal outcomes in pregnancies following bariatric surgery, as well as the impact on children, have all been positive.
Weight-loss surgery (also known as bariatric or gastric bypass surgery) is becoming increasingly popular; from 1996 to 2004, the number of patients who had gastric bypass surgery grew nine-fold. But how do these procedures alter the process of becoming pregnant and the pregnancy itself? Here are six things about it that you should be aware of.
- You may have an improvement in fertility
Bariatric surgery can result in a significant increase in your fertility. Women with reproductive issues connected to obesity who have the operation can start ovulating consistently for the first time in years, according to a study published in the Journal of Obstetric, Gynecologic, and Neonatal Nursing.
If you have polycystic ovarian syndrome (PCOS), the operation should improve your fertility. Weight reduction after surgery for women with PCOS cured metabolic and reproductive problems, according to a research published in the Journal of Clinical Endocrinology and Metabolism in December 2005.
Important caveat: If you haven’t been taking birth control, your increased fertility might increase your chances of becoming pregnant by mistake, which can be an issue if you’re in the first 18 months after surgery.
- You should wait at least 18 months before trying to conceive
Following your weight has stabilized, it is safe to become pregnant after bariatric surgery. Your body goes through potentially stressful changes after surgery, as well as major dietary upheaval, which might cause issues for a growing baby. Pregnancy is not a problem following weight-loss surgery. The only thing to be concerned about is becoming pregnant during a period of rapid weight reduction.
Doctors advise women not to get pregnant for at least 18 months following surgery to protect themselves and their newborns from malnutrition.
Getting pregnant at least 18 months following surgery minimizes the “risk for maternal and foetal malnutrition and small-for-gestational-age newborns,” according to a study published in the Journal of Obstetric, Gynecologic, and Neonatal Nursing. A mother should have attained a steady weight and be able to offer appropriate sustenance to her kid by then, according to physicians’ recommendations.
- You’ll need to keep a tight eye on your nutritional intake
Many women have nutritional deficits that might be significant during pregnancy, even after the immediate post-surgery phase has passed. The most prevalent nutritional issues connected with bariatric surgery, according to a research published in Medical Science, include deficits in B12, iron, calcium, and vitamin D. Post-surgery patients may have protein-calorie malnutrition and fat malabsorption in some circumstances. Many women consume as few as 500 calories per day after surgery and must take additional vitamins to compensate for the changes in how their bodies digest nutrition.
Because of nausea, a frequent post-surgery problem that morning sickness can increase, getting the nutrition you need during pregnancy may be more challenging. If nausea has taken away your appetite or you can’t keep food down, talk to your doctor about antinausea medications that are safe to use while pregnant.
Consult a dietician who is familiar with weight-loss surgery to ensure that you and your baby are getting adequate nourishment. Tell her about your operation, how much weight you’ve gained so far throughout your pregnancy, and your food preferences. She could advise you to consume multiple small meals throughout the day to help with nutritional absorption.
You should also get your vitamin levels checked on a regular basis by your healthcare practitioner. She could advise you to take more vitamin pills.
- You may need to educate your obstetrician-gynecologist
Because the weight-loss surgery craze is so new, many ob-gyns aren’t sure how to treat women who have had it. Moms who have undergone the procedure say they’ve been forced to educate their obstetricians.
If you’ve undergone weight-loss surgery and are pregnant or want to get pregnant, it is advisable to talk to all of your healthcare doctors as soon as possible. This will allow them to do research and ensure that they have the most up-to-date information while caring for your health.
- You may be fighting a struggle with your body image
Body image is one of the most significant emotional repercussions of pregnancy for post-surgery women. A woman must not only adjust to the fact that her belly will expand again, but she may also have scars from the operation that do not stretch properly as she grows.
Psychologically, many women who have had weight-loss surgery have a difficult time understanding that they must gain weight. They must learn to accept the idea that ‘Yes, now is the time to acquire weight.’ Another aspect of pregnancy that is emotionally draining is that it is stressful, and people tend to eat when they are upset.
As a result, women face the danger of going to extremes — either dieting while pregnant, which can have major nutritional effects for the baby, or regaining some of the weight they lost by consuming more food. There’s also the issue of food pushers to consider. These are the ones who tell you, “Go ahead, take another slice of cake!” when you’re pregnant.
During her pregnancy, a patient expressed concern about gaining weight. “Everyone told me I shouldn’t be concerned about gaining weight,” she adds. “But getting weight was my greatest dread. It’s tough because you might be dieting even if you don’t realize it. Before you eat, think about the kid so you’re thinking about what’s best for him.”
- You have a higher chance of having a caesarean section
According to a research published in the journal Obstetrics and Gynecology, pregnant women who have had bariatric surgery are more likely to have a c-section. It’s unclear why this is the case or what factors are at play, but speaking with your healthcare practitioner can assist.
Is your provider recommending a c-section for you, and if so, why? Inquire about your provider’s c-section rate and c-section philosophy generally. Is the provider okay with you trying vaginal delivery if you don’t have any major health issues? What may induce your provider to recommend a c-section intervention during a vaginal delivery?
Following your doctor’s weight-gain recommendations, exercising throughout pregnancy, and attending delivery preparation programmes may also help you avoid a c-section.
NOBesity is Best Bariatric Surgery Center in Ahmedabad – Get in touch to clear all your doubts related pre & post bariatric surgery.
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